Sunday, March 07, 2010

Pass the damn bill (#10) - Theda Skocpol

In a post I wrote back in December 2009, Theda Skocpol on health care reform, then and now, I noted that anything Theda Skocpol has to say about the politics of social policy in the US has to be taken very seriously, and that definitely includes her interventions in debates over the politics, political economy, and policy substance of the current health care reform effort. I also pointed out that, if one followed these interventions over the course of 2009, one could see her shift from a go-for-broke message earlier in the year to an emphasis on seizing the opportunity for a flawed and incomplete but valuable and realistically achievable reform package. I said then, and to avoid any possible misunderstanding I will say again now, that this comparison wasn't intended as a criticism. Instead, considering the evolution of Skocpol's arguments about these issues helps to illuminate some of the deepest, most difficult, and most genuinely intractable dilemmas involved in this whole political struggle.

By December 2009 (how long ago that seems now), this is was Skocpol's central conclusion:

The 2009 health reform end game -- yes, the end of the beginning is in sight -- has been excruciating for progressives. [....] Understandably, some progressives see what's left at the end of these struggles as not worth their support. But history tells us this is mistaken. We should take the many big steps forward that are on the table now -- above all the expanded entitlement, the regulations of private insurance, and the increased subsidies for the less fortunate -- and accept that true "health care reform" remains a multi-year, multi-election struggle.

=> Then the political earthquake set off by Scott Brown's election to the Senate from Massachusetts appeared to have derailed the whole health care reform effort, and for a while Democrats were either sunk in depression, running around in a panic like chickens with their heads cut off, or both. But now the final push is back on track, and with it what we can now recognize as the real moment of truth. Realistically, the only two possible outcomes--and it's important to emphasize that either one could still happen--are the passage of something close to the Senate version of the health care reform bill (with a package of fixes enacted separately via reconciliation) or a total debacle. Skocpol's message at this point is unambiguous and, in my opinion, unambiguously correct: Pass The Damn Bill. Some highlights:

The next two to three weeks will determine whether the United States gets on a better track toward including all citizens in health coverage and controlling costs in the public interest. This is NOT the moment for Democrats to posture and bargain [....]

At the risk of irritating people on the left, this is NOT the moment for "progressives" to demand a public option. Nor is it the moment for either pro-choice feminists or pro-life Democrats to derail reform. [....]

PROGRESSIVES need to cut the posturing over a currently unattainable (and in any event already hollowed out version of the) "public option." [....]"FEMINISTS" who are pushing on abortion-funding limits rather than supporting American women need to examine their consciences. [....] At issue now is a health reform that will extend critical resources to millions of ordinary women. [....]CATHOLIC PRO-LIFE DEMOCRATS also need to get a grip on core values. Do they -- or the U.S. Catholic Bishops -- really want to be responsible for scuttling access to health care for millions? Many deaths will be on their hands if they do. [....] Other Democrats should not follow Stupak. And responsible Catholic leaders should support the true "pro-life" cause here: expanded, affordable health care coverage for all Americans.

We will know soon if Democrats can pull together over what they have claimed for decades is a core party goal. If the posturing doesn't stop and the bills do not pass by Easter, comprehensive health reform will almost certainly go down the drain. The United States will descend further into gridlock and galloping inequalities, not least in access to basic health care.

The next two to three weeks will determine whether the United States gets on a better track toward including all citizens in health coverage and controlling costs in the public interest. This is NOT the moment for Democrats to posture and bargain -- remember, this is in part what lost us MA, that mess in the Senate over the Cornhusker Kickback and other unseemly deals. Scott Brown made use of these deals -- he pointed to Democratic dysfunctionality. Speed and simplicity are crucial right now, as Obama and the House and Senate leaders put together what they must to get this done. This is a time for the Indians to listen to the Chiefs.

At the risk of irritating people on the left, this is NOT the moment for "progressives" to demand a public option. Nor is it the moment for either pro-choice feminists or pro-life Democrats to derail reform.

PROGRESSIVES need to cut the posturing over a currently unattainable (and in any event already hollowed out version of the) "public option." To get legislation now that includes massive subsidies for the uninsured and a new regulatory framework for the future requires that Nancy Pelosi -- the real heroine in all this -- persuade shakey conservative Dems in the House. The legislation cannot include a public option if she is to succeed. Yet if this new framework passes through House action and a reconciliation side-car, that will open new political possibilities in the future. Before long, it will become very possible to enact Medicare extensions or a public option through majority budget votes, because they will be deficit-fighters. Especially "Medicare for More" which will be my new slogan. At this juncture, I hate to get emails from so-called progressive advocacy groups pushing for anything other than supporting Obama in the current end-game. Criticizing what is now attainable is the real defeatism, Adam Green! Conservatives are hammering wavering moderate Dems; use your resources to run moderate ads against private insurers in their districts. Praise the President's plan and help him get the votes. Same for MoveOn.

As for PRO-CHOICE versus PRO-LIFE advocates, give us all a break from your extremist posturings, please. Health care for all is probably the single most important issue for women and families and actual babies and children.

"FEMINISTS" who are pushing on abortion-funding limits rather than supporting American women need to examine their consciences. NOW's obsession over abortion is, in effect, betraying a long tradition of American women's advocacy on behalf of the wellbeing of families and the poor. Poor women cannot now get publicly funded abortions, and middle class women will always get what they need. At issue now is a health reform that will extend critical resources to millions of ordinary women.

CATHOLIC PRO-LIFE DEMOCRATS also need to get a grip on core values. Do they -- or the U.S. Catholic Bishops -- really want to be responsible for scuttling access to health care for millions? Many deaths will be on their hands if they do. Scuttling reform over abortion will give the lie to "pro life" claims. Abortion funding is not directly available through public funds -- it has not been for a long time, and it won't be under this legislation. Congressman Stupak, one suspects, really wants to defeat comprehensive health reform; he was conspiring with Republican leaders in the last episode. Other Democrats should not follow Stupak. And responsible Catholic leaders should support the true "pro-life" cause here: expanded, affordable health care coverage for all Americans.

We will know soon if Democrats can pull together over what they have claimed for decades is a core party goal. If the posturing doesn't stop and the bills do not pass by Easter, comprehensive health reform will almost certainly go down the drain. The United States will descend further into gridlock and galloping inequalities, not least in access to basic health care.

Links to this post:

About Me

Jeff Weintraub is a social & political theorist, political sociologist, and democratic socialist who has been teaching most recently at the University of Pennsylvania and Bryn Mawr College. He was a Visiting Scholar at the Center for European Studies at Harvard University in 2015-2016 and is currently a Research Associate at the Graduate School of Social Work and Social Research, Bryn Mawr College.
(Also an Affiliated Professor with the University of Haifa in Israel & an opponent of academic blacklists.)